Phage Directory expands! What’s changing and what’s staying the same

How we handle requests for phage therapy

Many of you know Phage Directory as a directory that helps people get emergency phage therapy. Although we are expanding our scope to include a much larger focus on supporting phage research, and to support phage use in all industries, we will still continue to help coordinate emergency phage therapy efforts around the world.

We wanted to take this opportunity to make it clear what we ARE doing when it comes to emergency phage therapy, along with a few things we don’t do, just so it’s clear going forward.

We maintain two phage therapy tools for emergency phage therapy purposes:

1. Phage Host Directory: A directory, searchable by pathogen, to find labs with phages against a given bacterial target.
2. Phage Alerts: A subscription service we use to tell the community when we have an emergency phage hunt going on.

Important points about these tools

• Both the phage host directory and the alert service are opt-in, so they only include labs and individuals who’ve signed up.
• While anyone can subscribe to receive alerts, we only send out alerts when a physician is on board.

Our stance on phage therapy

We believe phage therapy should only be done under the supervision of a physician. When a patient or patient family member reaches out to us asking for phages, we find out first whether they’ve spoken to their physician about phage therapy.

Where do our phage requests come from?

Most of our phage therapy requests come from patients or family members of patients, and they rarely come from physicians. Because of this, most requests do not result in alerts being sent out or phages being exchanged.

How we handle phage requests

If a patient does not have a physician willing to try phage therapy

Usually, patients who contact us either haven’t talked to their doctor, or they’ve tried, but their doctor does not wish to pursue phage therapy. In these cases, we do not send out a phage alert, but instead we explain that phage therapy can be done at the Eliava Institute, the Phage Therapy Unit in Wroclaw, the Queen Astrid Military Hospital, or IPATH. We provide links and contact info for these centers (find these on our Phage Therapy page here). It’s then up to the patient whether or not they seek phage therapy at these centers.

If a patient can’t or doesn’t wish to travel for phage therapy

Understandably, many patients are not in a position to travel to another country for phage therapy. If this is the case, we return to the question of whether they have a physician on board who will agree to provide phage therapy for them.

If the patient cannot or will not travel for phage therapy, and cannot find a local physician to attempt phage therapy on their behalf, we offer to help them find a physician in their area.

If a patient’s physician is willing to try phage therapy

If a patient has a physician on board, we speak with the physician about what we can do to help them find sources of phages. If they wish to put out a phage alert, we put that together for them and send it to our subscribers.

We identify phage labs willing to help test and prepare phages for the patient, and we connect the physician with other physicians in our network who have done phage therapy before.

From there, the physician takes the reins and approaches the relevant regulatory agency, and our role becomes one of connecting researchers with the treating physician, making sure everyone has each other’s shipping addresses, answering basic questions about what’s been done and what needs to be done, etc.

Learn more about how we’ve done this in the past:

• McCallin, S., Sacher, J. C., Zheng, J., and Chan, B. K. (2019) Current State of Compassionate Phage Therapy. Viruses, 11(4), 343. DOI: 10.3390/v11040343
• Sacher, J. C., McCallin, S., and Zheng, J. (2019) Sourcing Phages for Compassionate Use. Microbiology Australia
• Our Capsid & Tail articles on phage crowdsourcing here and here

When no phages can be found

Even if a physician is on board, sometimes, a patient is dealing with an infection for which no phage therapy center has phages (e.g. Mycoplasma, Ureaplasma infections), and no research labs respond to our phage alert.

In these cases, we may send out a tweet asking the phage community whether anyone knows of research labs working on these phages. We do a search of the literature and we reach out to labs who have published on these organisms in the context of phages. Usually, this doesn’t turn up much, and we have to tell the patient that there’s nothing we can do, other than to keep them posted if we do find out about a lab working on the kind of phages they need.

What we don’t do

We don’t provide medical advice, and we don’t store patient medical information. We don’t help patients find phages to treat themselves on their own. We don’t have our own phages, and we don’t do any of the wet lab work related to preparing phages.

Summary

We help physicians find research labs that can provide phages for emergency medical cases. When we receive a request for phages from a patient or patient family member, the first thing we do is emphasize that phage therapy should be done under the supervision of a physician.

If the patient cannot find a physician willing to try phage therapy with them, we provide information about phage therapy centers abroad.

If a patient’s physician is on board, we speak to the physician about what we can do to help them source phages for their patient.

We maintain two tools for emergency phage therapy cases: a self-serve directory of labs and their phages and an alert service we use to send emergency phage requests to the phage community (the latter are only sent out when a physician is involved).

After we send out a phage alert, labs willing to help get in touch with us by email. We connect labs with the treating physician, and if needed, we help guide labs through the process of helping with the case.

Get in touch with us!

If you’re a physician or a researcher working with physicians on phage therapy cases, know that you can always get in touch with us by emailing therapy@phage.directory.

We’re happy to help you find labs, phages, other physicians with phage therapy experience, get answers to your shipping or regulatory questions, and more. And if we can’t answer your question, we’ll do our best to connect you with someone in the community who can.